Survey of intravitreal injection techniques and treatment protocols among retina specialists in Canada.

Abstract

OBJECTIVE:

To describe intravitreal injection (IVI) techniques and treatment protocols by retina specialists in Canada from August 1, 2012, to October 1, 2012.

DESIGN:

Cross-sectional survey.

PARTICIPANTS:

All fellowship-trained retina specialists across Canada, as identified from the Canadian Ophthalmological Society directory and the Canadian Retina and Vitreous Society directory.

METHODS:

An anonymous 28-question survey was sent to 125 retina specialists across Canada by email. Reminder letters were sent by email, mail, and fax as necessary.

RESULTS:

A total of 75 (63%) retina specialists responded to the survey. Most IVIs were performed in the office. Most surgeons did not use gloves (61%), sterile draping (91%), or surgical mask (71%). Antisepsis was used on conjunctiva by 100% and on periocular skin by 48%. Nearly all specialists used a sterile lid speculum (91%). Common anaesthetics included topical proparacaine or lidocaine drops (90%), topical lidocaine gel (25%), topical pledget (23%), and subconjunctival lidocaine injections (23%). Most (83%) dilate the pupil before IVI. Prophylactic topical antibiotics were used by 43%; 50% of these were started immediately after IVI. Injection location was estimated by visualization by 45%. A majority (63%) inject inferotemporally. Anterior chamber paracentesis was performed routinely by 5%. Optic nerve perfusion was formally assessed by 48%. The most common treatment protocol for age-related macular degeneration was treat and extend. For both diabetic and retinal vein occlusion-related macular edema, the most common protocol was 3 initial monthly injections with PRN follow-up.

CONCLUSIONS:

A wide variety of IVI practice patterns exist in terms of aseptic technique, anaesthetics, prophylactic antibiotics, postinjection monitoring, and treatment protocol.

• Authors: Lin Xing, Stephen J Dorrepaal, Jeffrey Gale
• Journal: Canadian journal of ophthalmology. Journal canadien d'ophtalmologie (Can J Ophthalmol) Vol. 49 Issue 3 Pg. 261-6 (Jun 2014) ISSN: 1715-3360 [Electronic] England
• PMID: 24862772 (Publication Type: Journal Article)
• Copyright: Copyright © 2014 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

Chemical References

• Anti-Bacterial Agents
• Ophthalmic Solutions

Topics

• Administration, Topical
• Anesthesia, Local (statistics & numerical data)
• Anti-Bacterial Agents (administration & dosage)
• Canada
• Clinical Protocols
• Cross-Sectional Studies
• Female
• Health Surveys
• Humans
• Intravitreal Injections (methods, statistics & numerical data)
• Macular Degeneration (drug therapy)
• Macular Edema (drug therapy)
• Male
• Middle Aged
• Ophthalmic Solutions (administration & dosage)
• Ophthalmology
• Practice Patterns, Physicians'
• Retina
• Retinal Diseases (drug therapy)
• Retinal Vein Occlusion (drug therapy)
• Specialization
• Surveys and Questionnaires